Flu Crisis Preparation Called Poor

The world is teetering on the verge of a massive influenza outbreak, and even wealthy nations such as the United States are unprepared for the next pandemic, according to a report released Tuesday.

The report by the Washington-based Institute of Medicine does not predict when an outbreak might occur, but it says ingredients for a virulent flu strain are brewing in Asia.

At least eight Asian countries are dealing with avian flu, which continues to spread among birds and, occasionally, to people. But the deadly virus may be only "a few mutations away" from turning into a form that can be passed easily from person to person, the report concludes.

This year's vaccine shortage in the United States, the report notes, underlines a key vulnerability: the serious lack of flu-shot production worldwide.

They estimate that as many as 8 million could die worldwide in the next pandemic, including 207,000 in the United States. The last century's worst flu outbreak occurred in 1918, when 500,000 Americans and an estimated 20 million people worldwide perished from the Spanish flu.

"Most infectious-disease experts believe the world stands on the verge of an influenza pandemic," the report states. "Yet despite the legacy of the 1918 Spanish flu, ... the general public appears relatively unconcerned about the next `killer flu.'"